1 Month 2 Months 3 Months Other (requires approval by Membership Director. Specify the length of time and why in comments below)

For draft members, a freeze begins with an upcoming draft date and ends the day before a draft date. A freeze can be for one, two or three months. Any additional adjustments to this freeze will also require 15 days written notification.

Freeze begin date (must match current drafting schedule):
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Freeze end date (date draft/invoice will resume):
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Freeze begin date:

Month Day Year

Freeze end date (date draft/invoice will resume):

Month Day Year

Comments:

By signing (typing) my name below, I acknowledge that I am the primary account holder of the membership and that the above information is correct. I understand that it will require 15 days to affect my bank draft and I am responsible for any payments within the 15 day period. I understand that my draft/invoice will automatically renew after my freeze end date and a confirmation of that specific date will be sent to the email address provided above. I will not have access to the YMCA and will receive the program participant rate for all programs until that date.
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